心理韧性在初产妇产后抑郁与自我接纳间的中介效应分析

Mediating Effect of Psychological Resilience between Postpartum Depression and Self-acceptance in Primiparous Women

目的分析心理韧性在初产妇产后抑郁与自我接纳间的中介效应。方法回顾性收集简阳市人民医院和简阳市妇幼保健院2023年4月-2023年10月行产后复查的780例初产妇的临床资料,包括初产妇一般资料以及爱丁堡产后抑郁量表(EPDS,评分≥13分提示存在产褥期抑郁症)、自我接纳量表(SAQ,评分越高,提示初产妇自我接纳程度越高)、心理韧性量表(CD-RISC,评分越高,提示初产妇心理韧性水平越高)等检测资料。通过相关性分析、结构方程模型以及Bootstrap法对初产妇产后抑郁、自我接纳、心理韧性之间的关系进行分析。结果产后抑郁的初产妇共142例,产后抑郁发病率为18.21%,初产妇EPDS(总分0~30分)、SAQ(总分32~128分)、CD-RISC(总分0~100分)评分均值分别为(7.68±2.31)分、(44.27±4.38)分、(64.75±15.45)分;Logistic回归分析显示,心理韧性、自我接纳是初产妇产后抑郁的保护因素,心理韧性是初产妇自我接纳的保护因素(P<0.05);经Spearman相关性分析,初产妇EPDS评分与SAQ评分呈负相关,EPDS评分与CD-RISC评分呈负相关,SAQ评分与CD-RISC评分呈正相关(r值分别为-0.631、-0.682、0.657,P<0.05);初产妇心理韧性在产后抑郁与自我接纳之间发挥中介作用,中介效应在总效应中占比23.88%。结论初产妇产后抑郁风险较高,且与心理韧性、自我接纳相关,均可对其产后抑郁形成影响,且其心理韧性也间接影响其自我接纳程度。

Objective To analyze the mediating effect of psychological resilience between postpartum depression and self-acceptance in primiparous women.Methods The clinical data of 780 primiparous women who completed postpartum follow-up in Jianyang People's Hospital and Jianyang Maternal and Child Health Hospital from April to October 2023 were collected retrospectively,which included general information,the Edinburgh Postnatal Depression Scale(EPDS,a score of≥13 indicates puerperal depression)scores,Self Acceptance Questionnaire(SAQ,higher scores indicate higher self-acceptance in primiparous women)scores and Connor-Davidson Resilience Scale(CD-RISC,the higher the score,the higher the level of resilience of primiparous women)scores.The correlation among postpartum depression,self-acceptance and psychological resilience in primiparous women was analyzed through correlation analysis,structural equation modeling and Bootstrap method.Results In this study,a total of 142 primiparous women had postpartum depression,with an incidence rate of 18.21%.The average scores of EPDS(The total score is 0-30 points),SAQ(The total score is 32-128 points)and CD-RISC(The total score is 0-100 points)were(7.68±2.31),(44.27±4.38)and(64.75±15.45).Logistic regression analysis showed that resilience and self-acceptance were the protective factors for postpartum depression in primiparous women,and resilience was the protective factor for self-acceptance in primiparous women(P<0.05).Spearman correlation analysis found that the EPDS score was negatively correlated with the SAQ score,the EPDS score was negatively correlated with the CD-RISC score,and the SAQ score was positively correlated with the CD-RISC score(r=-0.631,-0.682,0.657,P<0.05).Psychological resilience played a mediating role between postpartum depression and self-acceptance,and the mediating effect accoun-ting for 23.88%of the total effect.Conclusion The risk of postpartum depression in primiparous women is high,and it is related to resilience and self-acceptance,which can affect their postpartum depression,and their resilience also indirectly affects their self-acceptance.